Provider Demographics
NPI:1033454137
Name:RHOADES, JASON ANTHONY (HOME HEALTH AIDE)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:ANTHONY
Last Name:RHOADES
Suffix:
Gender:M
Credentials:HOME HEALTH AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 S FRONT AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLEPORT
Mailing Address - State:OH
Mailing Address - Zip Code:45760-1435
Mailing Address - Country:US
Mailing Address - Phone:740-416-4326
Mailing Address - Fax:
Practice Address - Street 1:655 S FRONT AVE
Practice Address - Street 2:
Practice Address - City:MIDDLEPORT
Practice Address - State:OH
Practice Address - Zip Code:45760-1435
Practice Address - Country:US
Practice Address - Phone:740-416-4326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-01
Last Update Date:2012-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide